MEDICARE: STELLA DIAI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	37PC00562200	NJ
2	101YP2500X	Professional Counselor	PC016572	PA

General Provider Information

NPI Number	:	1619320462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STELLA DIAI

Provider Business Mailing Address
First Line	:	14335 59TH CIR E
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34211-0741
Country	:	US
Telephone Number	:	201-283-6955
Fax Number	:	941-281-2129

Provider Business Practice Location Address
First Line	:	2040 MILLBURN AVE
Second Line	:
City	:	MAPLEWOOD
State	:	NJ
Zip	:	07040-3726
Country	:	US
Telephone Number	:	201-283-6955
Fax Number	:	941-281-2129

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2016
Last Update Date	:	05/26/2026

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Directions to “ STELLA DIAI ” Practice Location

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